|
PR ARTHRS KNEE DRILLING OSTEOCHOND DISSECANS LESION
|
Professional
|
Both
|
$2,395.00
|
|
|
Service Code
|
HCPCS 29886
|
| Min. Negotiated Rate |
$616.75 |
| Max. Negotiated Rate |
$1,556.75 |
| Rate for Payer: Aetna Commercial |
$826.45
|
| Rate for Payer: Aetna Medicare |
$616.75
|
| Rate for Payer: BCBS Complete |
$958.00
|
| Rate for Payer: BCBS MAPPO |
$616.75
|
| Rate for Payer: BCN Medicare Advantage |
$616.75
|
| Rate for Payer: Cash Price |
$1,916.00
|
| Rate for Payer: Cash Price |
$1,916.00
|
| Rate for Payer: Cofinity Commercial |
$888.12
|
| Rate for Payer: Cofinity Commercial |
$826.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$616.75
|
| Rate for Payer: Healthscope Commercial |
$740.10
|
| Rate for Payer: Healthscope Whirlpool |
$740.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$647.59
|
| Rate for Payer: Nomi Health Commercial |
$740.10
|
| Rate for Payer: PACE SWMI |
$616.75
|
| Rate for Payer: PHP Medicare Advantage |
$616.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,556.75
|
| Rate for Payer: Priority Health Medicare |
$616.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$616.75
|
| Rate for Payer: UHC Medicare Advantage |
$616.75
|
| Rate for Payer: UHCCP DNSP |
$616.75
|
|
|
PR ARTHRS KNEE DRILL OSTEOCHONDRITIS DISSECANS GRFG
|
Professional
|
Both
|
$2,542.00
|
|
|
Service Code
|
HCPCS 29885
|
| Min. Negotiated Rate |
$731.43 |
| Max. Negotiated Rate |
$1,652.30 |
| Rate for Payer: Aetna Commercial |
$980.12
|
| Rate for Payer: Aetna Medicare |
$731.43
|
| Rate for Payer: BCBS Complete |
$1,016.80
|
| Rate for Payer: BCBS MAPPO |
$731.43
|
| Rate for Payer: BCN Medicare Advantage |
$731.43
|
| Rate for Payer: Cash Price |
$2,033.60
|
| Rate for Payer: Cash Price |
$2,033.60
|
| Rate for Payer: Cofinity Commercial |
$980.12
|
| Rate for Payer: Cofinity Commercial |
$1,053.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$731.43
|
| Rate for Payer: Healthscope Commercial |
$877.72
|
| Rate for Payer: Healthscope Whirlpool |
$877.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$768.00
|
| Rate for Payer: Nomi Health Commercial |
$877.72
|
| Rate for Payer: PACE SWMI |
$731.43
|
| Rate for Payer: PHP Medicare Advantage |
$731.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,652.30
|
| Rate for Payer: Priority Health Medicare |
$731.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$731.43
|
| Rate for Payer: UHC Medicare Advantage |
$731.43
|
| Rate for Payer: UHCCP DNSP |
$731.43
|
|
|
PR ARTHRS KNEE DRLG OSTEOCHOND DISSECANS INT FIXJ
|
Professional
|
Both
|
$2,525.00
|
|
|
Service Code
|
HCPCS 29887
|
| Min. Negotiated Rate |
$728.55 |
| Max. Negotiated Rate |
$1,641.25 |
| Rate for Payer: Aetna Commercial |
$976.26
|
| Rate for Payer: Aetna Medicare |
$728.55
|
| Rate for Payer: BCBS Complete |
$1,010.00
|
| Rate for Payer: BCBS MAPPO |
$728.55
|
| Rate for Payer: BCN Medicare Advantage |
$728.55
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Cofinity Commercial |
$976.26
|
| Rate for Payer: Cofinity Commercial |
$1,049.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$728.55
|
| Rate for Payer: Healthscope Commercial |
$874.26
|
| Rate for Payer: Healthscope Whirlpool |
$874.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$764.98
|
| Rate for Payer: Nomi Health Commercial |
$874.26
|
| Rate for Payer: PACE SWMI |
$728.55
|
| Rate for Payer: PHP Medicare Advantage |
$728.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,641.25
|
| Rate for Payer: Priority Health Medicare |
$728.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$728.55
|
| Rate for Payer: UHC Medicare Advantage |
$728.55
|
| Rate for Payer: UHCCP DNSP |
$728.55
|
|
|
PR ARTHRS KNEE W/MENISCECTOMY MED&LAT W/SHAVING
|
Professional
|
Both
|
$2,589.00
|
|
|
Service Code
|
HCPCS 29880
|
| Min. Negotiated Rate |
$542.34 |
| Max. Negotiated Rate |
$1,682.85 |
| Rate for Payer: Aetna Commercial |
$726.74
|
| Rate for Payer: Aetna Medicare |
$542.34
|
| Rate for Payer: BCBS Complete |
$1,035.60
|
| Rate for Payer: BCBS MAPPO |
$542.34
|
| Rate for Payer: BCN Medicare Advantage |
$542.34
|
| Rate for Payer: Cash Price |
$2,071.20
|
| Rate for Payer: Cash Price |
$2,071.20
|
| Rate for Payer: Cofinity Commercial |
$780.97
|
| Rate for Payer: Cofinity Commercial |
$726.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$542.34
|
| Rate for Payer: Healthscope Commercial |
$650.81
|
| Rate for Payer: Healthscope Whirlpool |
$650.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$569.46
|
| Rate for Payer: Nomi Health Commercial |
$650.81
|
| Rate for Payer: PACE SWMI |
$542.34
|
| Rate for Payer: PHP Medicare Advantage |
$542.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,682.85
|
| Rate for Payer: Priority Health Medicare |
$542.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$542.34
|
| Rate for Payer: UHC Medicare Advantage |
$542.34
|
| Rate for Payer: UHCCP DNSP |
$542.34
|
|
|
PR ARTHRS KNEE W/MENISCECTOMY MED&LAT W/SHAVING
|
Professional
|
Both
|
$2,589.00
|
|
|
Service Code
|
HCPCS 29880
|
| Hospital Charge Code |
29880
|
| Min. Negotiated Rate |
$542.34 |
| Max. Negotiated Rate |
$1,682.85 |
| Rate for Payer: Aetna Commercial |
$726.74
|
| Rate for Payer: Aetna Medicare |
$542.34
|
| Rate for Payer: BCBS Complete |
$1,035.60
|
| Rate for Payer: BCBS MAPPO |
$542.34
|
| Rate for Payer: BCN Medicare Advantage |
$542.34
|
| Rate for Payer: Cash Price |
$2,071.20
|
| Rate for Payer: Cash Price |
$2,071.20
|
| Rate for Payer: Cofinity Commercial |
$780.97
|
| Rate for Payer: Cofinity Commercial |
$726.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$542.34
|
| Rate for Payer: Healthscope Commercial |
$650.81
|
| Rate for Payer: Healthscope Whirlpool |
$650.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$569.46
|
| Rate for Payer: Nomi Health Commercial |
$650.81
|
| Rate for Payer: PACE SWMI |
$542.34
|
| Rate for Payer: PHP Medicare Advantage |
$542.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,682.85
|
| Rate for Payer: Priority Health Medicare |
$542.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$542.34
|
| Rate for Payer: UHC Medicare Advantage |
$542.34
|
| Rate for Payer: UHCCP DNSP |
$542.34
|
|
|
PR ARTHRS KNEE W/MENISCECTOMY MED&LAT W/SHAVING
|
Facility
|
OP
|
$2,589.00
|
|
|
Service Code
|
CPT 29880
|
| Hospital Charge Code |
29880
|
| Min. Negotiated Rate |
$1,682.85 |
| Max. Negotiated Rate |
$4,904.82 |
| Rate for Payer: Aetna Commercial |
$2,330.10
|
| Rate for Payer: Aetna Medicare |
$3,164.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,955.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,955.50
|
| Rate for Payer: ASR ASR |
$2,511.33
|
| Rate for Payer: ASR Commercial |
$2,511.33
|
| Rate for Payer: BCBS Complete |
$1,780.92
|
| Rate for Payer: BCBS MAPPO |
$3,164.40
|
| Rate for Payer: BCBS Trust/PPO |
$2,120.13
|
| Rate for Payer: BCN Commercial |
$2,007.25
|
| Rate for Payer: BCN Medicare Advantage |
$3,164.40
|
| Rate for Payer: Cash Price |
$2,071.20
|
| Rate for Payer: Cash Price |
$2,071.20
|
| Rate for Payer: Cofinity Commercial |
$2,433.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,071.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,164.40
|
| Rate for Payer: Healthscope Commercial |
$2,589.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,511.33
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,164.40
|
| Rate for Payer: Mclaren Commercial |
$2,330.10
|
| Rate for Payer: Mclaren Medicaid |
$1,696.12
|
| Rate for Payer: Mclaren Medicare |
$3,164.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,322.62
|
| Rate for Payer: Meridian Medicaid |
$1,780.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,639.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,200.65
|
| Rate for Payer: Nomi Health Commercial |
$2,122.98
|
| Rate for Payer: PACE Medicare |
$3,006.18
|
| Rate for Payer: PACE SWMI |
$3,164.40
|
| Rate for Payer: PHP Commercial |
$3,480.84
|
| Rate for Payer: PHP Medicaid |
$1,696.12
|
| Rate for Payer: PHP Medicare Advantage |
$3,164.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,696.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,682.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,268.48
|
| Rate for Payer: Priority Health Medicare |
$3,164.40
|
| Rate for Payer: Priority Health Narrow Network |
$1,814.89
|
| Rate for Payer: Railroad Medicare Medicare |
$3,164.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,278.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,164.40
|
| Rate for Payer: UHC Exchange |
$4,904.82
|
| Rate for Payer: UHC Medicare Advantage |
$3,164.40
|
| Rate for Payer: UHCCP DNSP |
$3,164.40
|
| Rate for Payer: UHCCP Medicaid |
$1,696.12
|
| Rate for Payer: VA VA |
$3,164.40
|
|
|
PR ARTHRS KNEE W/MENISCECTOMY MED&LAT W/SHAVING
|
Facility
|
IP
|
$2,589.00
|
|
|
Service Code
|
CPT 29880
|
| Hospital Charge Code |
29880
|
| Min. Negotiated Rate |
$1,682.85 |
| Max. Negotiated Rate |
$2,589.00 |
| Rate for Payer: Aetna Commercial |
$2,330.10
|
| Rate for Payer: ASR ASR |
$2,511.33
|
| Rate for Payer: ASR Commercial |
$2,511.33
|
| Rate for Payer: BCBS Trust/PPO |
$2,109.78
|
| Rate for Payer: BCN Commercial |
$2,007.25
|
| Rate for Payer: Cash Price |
$2,071.20
|
| Rate for Payer: Cofinity Commercial |
$2,433.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,071.20
|
| Rate for Payer: Healthscope Commercial |
$2,589.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,511.33
|
| Rate for Payer: Mclaren Commercial |
$2,330.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,200.65
|
| Rate for Payer: Nomi Health Commercial |
$2,122.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,682.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,278.32
|
|
|
PR ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG
|
Professional
|
Both
|
$2,395.00
|
|
|
Service Code
|
HCPCS 29881
|
| Hospital Charge Code |
29881
|
| Min. Negotiated Rate |
$522.36 |
| Max. Negotiated Rate |
$1,556.75 |
| Rate for Payer: Aetna Commercial |
$699.96
|
| Rate for Payer: Aetna Medicare |
$522.36
|
| Rate for Payer: BCBS Complete |
$958.00
|
| Rate for Payer: BCBS MAPPO |
$522.36
|
| Rate for Payer: BCN Medicare Advantage |
$522.36
|
| Rate for Payer: Cash Price |
$1,916.00
|
| Rate for Payer: Cash Price |
$1,916.00
|
| Rate for Payer: Cofinity Commercial |
$752.20
|
| Rate for Payer: Cofinity Commercial |
$699.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$522.36
|
| Rate for Payer: Healthscope Commercial |
$626.83
|
| Rate for Payer: Healthscope Whirlpool |
$626.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$548.48
|
| Rate for Payer: Nomi Health Commercial |
$626.83
|
| Rate for Payer: PACE SWMI |
$522.36
|
| Rate for Payer: PHP Medicare Advantage |
$522.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,556.75
|
| Rate for Payer: Priority Health Medicare |
$522.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$522.36
|
| Rate for Payer: UHC Medicare Advantage |
$522.36
|
| Rate for Payer: UHCCP DNSP |
$522.36
|
|
|
PR ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG
|
Professional
|
Both
|
$2,395.00
|
|
|
Service Code
|
HCPCS 29881
|
| Min. Negotiated Rate |
$522.36 |
| Max. Negotiated Rate |
$1,556.75 |
| Rate for Payer: Aetna Commercial |
$699.96
|
| Rate for Payer: Aetna Medicare |
$522.36
|
| Rate for Payer: BCBS Complete |
$958.00
|
| Rate for Payer: BCBS MAPPO |
$522.36
|
| Rate for Payer: BCN Medicare Advantage |
$522.36
|
| Rate for Payer: Cash Price |
$1,916.00
|
| Rate for Payer: Cash Price |
$1,916.00
|
| Rate for Payer: Cofinity Commercial |
$752.20
|
| Rate for Payer: Cofinity Commercial |
$699.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$522.36
|
| Rate for Payer: Healthscope Commercial |
$626.83
|
| Rate for Payer: Healthscope Whirlpool |
$626.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$548.48
|
| Rate for Payer: Nomi Health Commercial |
$626.83
|
| Rate for Payer: PACE SWMI |
$522.36
|
| Rate for Payer: PHP Medicare Advantage |
$522.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,556.75
|
| Rate for Payer: Priority Health Medicare |
$522.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$522.36
|
| Rate for Payer: UHC Medicare Advantage |
$522.36
|
| Rate for Payer: UHCCP DNSP |
$522.36
|
|
|
PR ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG
|
Facility
|
OP
|
$2,395.00
|
|
|
Service Code
|
CPT 29881
|
| Hospital Charge Code |
29881
|
| Min. Negotiated Rate |
$1,556.75 |
| Max. Negotiated Rate |
$4,904.82 |
| Rate for Payer: Aetna Commercial |
$2,155.50
|
| Rate for Payer: Aetna Medicare |
$3,164.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,955.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,955.50
|
| Rate for Payer: ASR ASR |
$2,323.15
|
| Rate for Payer: ASR Commercial |
$2,323.15
|
| Rate for Payer: BCBS Complete |
$1,780.92
|
| Rate for Payer: BCBS MAPPO |
$3,164.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,961.27
|
| Rate for Payer: BCN Commercial |
$1,856.84
|
| Rate for Payer: BCN Medicare Advantage |
$3,164.40
|
| Rate for Payer: Cash Price |
$1,916.00
|
| Rate for Payer: Cash Price |
$1,916.00
|
| Rate for Payer: Cofinity Commercial |
$2,251.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,916.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,164.40
|
| Rate for Payer: Healthscope Commercial |
$2,395.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,323.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,164.40
|
| Rate for Payer: Mclaren Commercial |
$2,155.50
|
| Rate for Payer: Mclaren Medicaid |
$1,696.12
|
| Rate for Payer: Mclaren Medicare |
$3,164.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,322.62
|
| Rate for Payer: Meridian Medicaid |
$1,780.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,639.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,035.75
|
| Rate for Payer: Nomi Health Commercial |
$1,963.90
|
| Rate for Payer: PACE Medicare |
$3,006.18
|
| Rate for Payer: PACE SWMI |
$3,164.40
|
| Rate for Payer: PHP Commercial |
$3,480.84
|
| Rate for Payer: PHP Medicaid |
$1,696.12
|
| Rate for Payer: PHP Medicare Advantage |
$3,164.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,696.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,556.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,098.50
|
| Rate for Payer: Priority Health Medicare |
$3,164.40
|
| Rate for Payer: Priority Health Narrow Network |
$1,678.89
|
| Rate for Payer: Railroad Medicare Medicare |
$3,164.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,107.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,164.40
|
| Rate for Payer: UHC Exchange |
$4,904.82
|
| Rate for Payer: UHC Medicare Advantage |
$3,164.40
|
| Rate for Payer: UHCCP DNSP |
$3,164.40
|
| Rate for Payer: UHCCP Medicaid |
$1,696.12
|
| Rate for Payer: VA VA |
$3,164.40
|
|
|
PR ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG
|
Facility
|
IP
|
$2,395.00
|
|
|
Service Code
|
CPT 29881
|
| Hospital Charge Code |
29881
|
| Min. Negotiated Rate |
$1,556.75 |
| Max. Negotiated Rate |
$2,395.00 |
| Rate for Payer: Aetna Commercial |
$2,155.50
|
| Rate for Payer: ASR ASR |
$2,323.15
|
| Rate for Payer: ASR Commercial |
$2,323.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,951.69
|
| Rate for Payer: BCN Commercial |
$1,856.84
|
| Rate for Payer: Cash Price |
$1,916.00
|
| Rate for Payer: Cofinity Commercial |
$2,251.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,916.00
|
| Rate for Payer: Healthscope Commercial |
$2,395.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,323.15
|
| Rate for Payer: Mclaren Commercial |
$2,155.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,035.75
|
| Rate for Payer: Nomi Health Commercial |
$1,963.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,556.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,107.60
|
|
|
PR ARTHRS SUBTALAR JOINT REMOVE LOOSE/FOREIGN BODY
|
Professional
|
Both
|
$2,395.00
|
|
|
Service Code
|
HCPCS 29904
|
| Min. Negotiated Rate |
$620.50 |
| Max. Negotiated Rate |
$1,556.75 |
| Rate for Payer: Aetna Commercial |
$831.47
|
| Rate for Payer: Aetna Medicare |
$620.50
|
| Rate for Payer: BCBS Complete |
$958.00
|
| Rate for Payer: BCBS MAPPO |
$620.50
|
| Rate for Payer: BCN Medicare Advantage |
$620.50
|
| Rate for Payer: Cash Price |
$1,916.00
|
| Rate for Payer: Cash Price |
$1,916.00
|
| Rate for Payer: Cofinity Commercial |
$893.52
|
| Rate for Payer: Cofinity Commercial |
$831.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$620.50
|
| Rate for Payer: Healthscope Commercial |
$744.60
|
| Rate for Payer: Healthscope Whirlpool |
$744.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$651.52
|
| Rate for Payer: Nomi Health Commercial |
$744.60
|
| Rate for Payer: PACE SWMI |
$620.50
|
| Rate for Payer: PHP Medicare Advantage |
$620.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,556.75
|
| Rate for Payer: Priority Health Medicare |
$620.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$620.50
|
| Rate for Payer: UHC Medicare Advantage |
$620.50
|
| Rate for Payer: UHCCP DNSP |
$620.50
|
|
|
PR ARTHRS WRST EXC&/RPR TRIANG FIBROCART&/JOINT
|
Professional
|
Both
|
$2,039.00
|
|
|
Service Code
|
HCPCS 29846
|
| Min. Negotiated Rate |
$505.49 |
| Max. Negotiated Rate |
$1,325.35 |
| Rate for Payer: Aetna Commercial |
$677.36
|
| Rate for Payer: Aetna Medicare |
$505.49
|
| Rate for Payer: BCBS Complete |
$815.60
|
| Rate for Payer: BCBS MAPPO |
$505.49
|
| Rate for Payer: BCN Medicare Advantage |
$505.49
|
| Rate for Payer: Cash Price |
$1,631.20
|
| Rate for Payer: Cash Price |
$1,631.20
|
| Rate for Payer: Cofinity Commercial |
$727.91
|
| Rate for Payer: Cofinity Commercial |
$677.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$505.49
|
| Rate for Payer: Healthscope Commercial |
$606.59
|
| Rate for Payer: Healthscope Whirlpool |
$606.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$530.76
|
| Rate for Payer: Nomi Health Commercial |
$606.59
|
| Rate for Payer: PACE SWMI |
$505.49
|
| Rate for Payer: PHP Medicare Advantage |
$505.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,325.35
|
| Rate for Payer: Priority Health Medicare |
$505.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$505.49
|
| Rate for Payer: UHC Medicare Advantage |
$505.49
|
| Rate for Payer: UHCCP DNSP |
$505.49
|
|
|
PR ARTHRT ACROMCLAV STRNCLAV JT EXPL/DRG/RMVL FB
|
Professional
|
Both
|
$1,225.00
|
|
|
Service Code
|
HCPCS 23044
|
| Min. Negotiated Rate |
$490.00 |
| Max. Negotiated Rate |
$796.25 |
| Rate for Payer: Aetna Commercial |
$727.12
|
| Rate for Payer: Aetna Medicare |
$542.63
|
| Rate for Payer: BCBS Complete |
$490.00
|
| Rate for Payer: BCBS MAPPO |
$542.63
|
| Rate for Payer: BCN Medicare Advantage |
$542.63
|
| Rate for Payer: Cash Price |
$980.00
|
| Rate for Payer: Cash Price |
$980.00
|
| Rate for Payer: Cofinity Commercial |
$781.39
|
| Rate for Payer: Cofinity Commercial |
$727.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$542.63
|
| Rate for Payer: Healthscope Commercial |
$651.16
|
| Rate for Payer: Healthscope Whirlpool |
$651.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$569.76
|
| Rate for Payer: Nomi Health Commercial |
$651.16
|
| Rate for Payer: PACE SWMI |
$542.63
|
| Rate for Payer: PHP Medicare Advantage |
$542.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$796.25
|
| Rate for Payer: Priority Health Medicare |
$542.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$542.63
|
| Rate for Payer: UHC Medicare Advantage |
$542.63
|
| Rate for Payer: UHCCP DNSP |
$542.63
|
|
|
PR ARTHRT ACROMCLAV/STRNCLAV JT W/BX&/EXC CRTLG
|
Professional
|
Both
|
$805.00
|
|
|
Service Code
|
HCPCS 23101
|
| Min. Negotiated Rate |
$322.00 |
| Max. Negotiated Rate |
$638.31 |
| Rate for Payer: Aetna Commercial |
$593.98
|
| Rate for Payer: Aetna Medicare |
$443.27
|
| Rate for Payer: BCBS Complete |
$322.00
|
| Rate for Payer: BCBS MAPPO |
$443.27
|
| Rate for Payer: BCN Medicare Advantage |
$443.27
|
| Rate for Payer: Cash Price |
$644.00
|
| Rate for Payer: Cash Price |
$644.00
|
| Rate for Payer: Cofinity Commercial |
$638.31
|
| Rate for Payer: Cofinity Commercial |
$593.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$443.27
|
| Rate for Payer: Healthscope Commercial |
$531.92
|
| Rate for Payer: Healthscope Whirlpool |
$531.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$465.43
|
| Rate for Payer: Nomi Health Commercial |
$531.92
|
| Rate for Payer: PACE SWMI |
$443.27
|
| Rate for Payer: PHP Medicare Advantage |
$443.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$523.25
|
| Rate for Payer: Priority Health Medicare |
$443.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$443.27
|
| Rate for Payer: UHC Medicare Advantage |
$443.27
|
| Rate for Payer: UHCCP DNSP |
$443.27
|
|
|
PR ARTHRT ANKLE W/EXPL W/WO BX W/WO RMVL LOOSE/FB
|
Professional
|
Both
|
$1,127.00
|
|
|
Service Code
|
HCPCS 27620
|
| Min. Negotiated Rate |
$432.11 |
| Max. Negotiated Rate |
$732.55 |
| Rate for Payer: Aetna Commercial |
$579.03
|
| Rate for Payer: Aetna Medicare |
$432.11
|
| Rate for Payer: BCBS Complete |
$450.80
|
| Rate for Payer: BCBS MAPPO |
$432.11
|
| Rate for Payer: BCN Medicare Advantage |
$432.11
|
| Rate for Payer: Cash Price |
$901.60
|
| Rate for Payer: Cash Price |
$901.60
|
| Rate for Payer: Cofinity Commercial |
$622.24
|
| Rate for Payer: Cofinity Commercial |
$579.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$432.11
|
| Rate for Payer: Healthscope Commercial |
$518.53
|
| Rate for Payer: Healthscope Whirlpool |
$518.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$453.72
|
| Rate for Payer: Nomi Health Commercial |
$518.53
|
| Rate for Payer: PACE SWMI |
$432.11
|
| Rate for Payer: PHP Medicare Advantage |
$432.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$732.55
|
| Rate for Payer: Priority Health Medicare |
$432.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$432.11
|
| Rate for Payer: UHC Medicare Advantage |
$432.11
|
| Rate for Payer: UHCCP DNSP |
$432.11
|
|
|
PR ARTHRT ELBOW CAPSULAR EXCISION CAPSULAR RLS SPX
|
Professional
|
Both
|
$2,063.00
|
|
|
Service Code
|
HCPCS 24006
|
| Min. Negotiated Rate |
$691.63 |
| Max. Negotiated Rate |
$1,340.95 |
| Rate for Payer: Aetna Commercial |
$926.78
|
| Rate for Payer: Aetna Medicare |
$691.63
|
| Rate for Payer: BCBS Complete |
$825.20
|
| Rate for Payer: BCBS MAPPO |
$691.63
|
| Rate for Payer: BCN Medicare Advantage |
$691.63
|
| Rate for Payer: Cash Price |
$1,650.40
|
| Rate for Payer: Cash Price |
$1,650.40
|
| Rate for Payer: Cofinity Commercial |
$995.95
|
| Rate for Payer: Cofinity Commercial |
$926.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$691.63
|
| Rate for Payer: Healthscope Commercial |
$829.96
|
| Rate for Payer: Healthscope Whirlpool |
$829.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$726.21
|
| Rate for Payer: Nomi Health Commercial |
$829.96
|
| Rate for Payer: PACE SWMI |
$691.63
|
| Rate for Payer: PHP Medicare Advantage |
$691.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,340.95
|
| Rate for Payer: Priority Health Medicare |
$691.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$691.63
|
| Rate for Payer: UHC Medicare Advantage |
$691.63
|
| Rate for Payer: UHCCP DNSP |
$691.63
|
|
|
PR ARTHRT ELBOW W/EXPLORATION DRAINAGE/REMOVAL FB
|
Professional
|
Both
|
$2,038.00
|
|
|
Service Code
|
HCPCS 24000
|
| Min. Negotiated Rate |
$464.93 |
| Max. Negotiated Rate |
$1,324.70 |
| Rate for Payer: Aetna Commercial |
$623.01
|
| Rate for Payer: Aetna Medicare |
$464.93
|
| Rate for Payer: BCBS Complete |
$815.20
|
| Rate for Payer: BCBS MAPPO |
$464.93
|
| Rate for Payer: BCN Medicare Advantage |
$464.93
|
| Rate for Payer: Cash Price |
$1,630.40
|
| Rate for Payer: Cash Price |
$1,630.40
|
| Rate for Payer: Cofinity Commercial |
$669.50
|
| Rate for Payer: Cofinity Commercial |
$623.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$464.93
|
| Rate for Payer: Healthscope Commercial |
$557.92
|
| Rate for Payer: Healthscope Whirlpool |
$557.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$488.18
|
| Rate for Payer: Nomi Health Commercial |
$557.92
|
| Rate for Payer: PACE SWMI |
$464.93
|
| Rate for Payer: PHP Medicare Advantage |
$464.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,324.70
|
| Rate for Payer: Priority Health Medicare |
$464.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$464.93
|
| Rate for Payer: UHC Medicare Advantage |
$464.93
|
| Rate for Payer: UHCCP DNSP |
$464.93
|
|
|
PR ARTHRT ELBOW W/JT EXPL W/WOBX W/O RMVL LOOSE/FB
|
Professional
|
Both
|
$1,348.00
|
|
|
Service Code
|
HCPCS 24101
|
| Min. Negotiated Rate |
$487.67 |
| Max. Negotiated Rate |
$876.20 |
| Rate for Payer: Aetna Commercial |
$653.48
|
| Rate for Payer: Aetna Medicare |
$487.67
|
| Rate for Payer: BCBS Complete |
$539.20
|
| Rate for Payer: BCBS MAPPO |
$487.67
|
| Rate for Payer: BCN Medicare Advantage |
$487.67
|
| Rate for Payer: Cash Price |
$1,078.40
|
| Rate for Payer: Cash Price |
$1,078.40
|
| Rate for Payer: Cofinity Commercial |
$702.24
|
| Rate for Payer: Cofinity Commercial |
$653.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$487.67
|
| Rate for Payer: Healthscope Commercial |
$585.20
|
| Rate for Payer: Healthscope Whirlpool |
$585.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$512.05
|
| Rate for Payer: Nomi Health Commercial |
$585.20
|
| Rate for Payer: PACE SWMI |
$487.67
|
| Rate for Payer: PHP Medicare Advantage |
$487.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$876.20
|
| Rate for Payer: Priority Health Medicare |
$487.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$487.67
|
| Rate for Payer: UHC Medicare Advantage |
$487.67
|
| Rate for Payer: UHCCP DNSP |
$487.67
|
|
|
PR ARTHRT EXPL DRG/RMVL LOOSE/FB CARP/MTCRPL JT
|
Professional
|
Both
|
$1,290.00
|
|
|
Service Code
|
HCPCS 26070
|
| Min. Negotiated Rate |
$313.14 |
| Max. Negotiated Rate |
$838.50 |
| Rate for Payer: Aetna Commercial |
$419.61
|
| Rate for Payer: Aetna Medicare |
$313.14
|
| Rate for Payer: BCBS Complete |
$516.00
|
| Rate for Payer: BCBS MAPPO |
$313.14
|
| Rate for Payer: BCN Medicare Advantage |
$313.14
|
| Rate for Payer: Cash Price |
$1,032.00
|
| Rate for Payer: Cash Price |
$1,032.00
|
| Rate for Payer: Cofinity Commercial |
$450.92
|
| Rate for Payer: Cofinity Commercial |
$419.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$313.14
|
| Rate for Payer: Healthscope Commercial |
$375.77
|
| Rate for Payer: Healthscope Whirlpool |
$375.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$328.80
|
| Rate for Payer: Nomi Health Commercial |
$375.77
|
| Rate for Payer: PACE SWMI |
$313.14
|
| Rate for Payer: PHP Medicare Advantage |
$313.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$838.50
|
| Rate for Payer: Priority Health Medicare |
$313.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$313.14
|
| Rate for Payer: UHC Medicare Advantage |
$313.14
|
| Rate for Payer: UHCCP DNSP |
$313.14
|
|
|
PR ARTHRT EXPL DRG/RMVL LOOSE/FB IPHAL JT EA
|
Professional
|
Both
|
$1,089.00
|
|
|
Service Code
|
HCPCS 26080
|
| Min. Negotiated Rate |
$385.98 |
| Max. Negotiated Rate |
$707.85 |
| Rate for Payer: Aetna Commercial |
$517.21
|
| Rate for Payer: Aetna Medicare |
$385.98
|
| Rate for Payer: BCBS Complete |
$435.60
|
| Rate for Payer: BCBS MAPPO |
$385.98
|
| Rate for Payer: BCN Medicare Advantage |
$385.98
|
| Rate for Payer: Cash Price |
$871.20
|
| Rate for Payer: Cash Price |
$871.20
|
| Rate for Payer: Cofinity Commercial |
$555.81
|
| Rate for Payer: Cofinity Commercial |
$517.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$385.98
|
| Rate for Payer: Healthscope Commercial |
$463.18
|
| Rate for Payer: Healthscope Whirlpool |
$463.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$405.28
|
| Rate for Payer: Nomi Health Commercial |
$463.18
|
| Rate for Payer: PACE SWMI |
$385.98
|
| Rate for Payer: PHP Medicare Advantage |
$385.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$707.85
|
| Rate for Payer: Priority Health Medicare |
$385.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$385.98
|
| Rate for Payer: UHC Medicare Advantage |
$385.98
|
| Rate for Payer: UHCCP DNSP |
$385.98
|
|
|
PR ARTHRT EXPL DRG/RMVL LOOSE/FB MTCARPHLNGL JT EA
|
Professional
|
Both
|
$573.00
|
|
|
Service Code
|
HCPCS 26075
|
| Min. Negotiated Rate |
$229.20 |
| Max. Negotiated Rate |
$472.36 |
| Rate for Payer: Aetna Commercial |
$439.56
|
| Rate for Payer: Aetna Medicare |
$328.03
|
| Rate for Payer: BCBS Complete |
$229.20
|
| Rate for Payer: BCBS MAPPO |
$328.03
|
| Rate for Payer: BCN Medicare Advantage |
$328.03
|
| Rate for Payer: Cash Price |
$458.40
|
| Rate for Payer: Cash Price |
$458.40
|
| Rate for Payer: Cofinity Commercial |
$472.36
|
| Rate for Payer: Cofinity Commercial |
$439.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$328.03
|
| Rate for Payer: Healthscope Commercial |
$393.64
|
| Rate for Payer: Healthscope Whirlpool |
$393.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$344.43
|
| Rate for Payer: Nomi Health Commercial |
$393.64
|
| Rate for Payer: PACE SWMI |
$328.03
|
| Rate for Payer: PHP Medicare Advantage |
$328.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$372.45
|
| Rate for Payer: Priority Health Medicare |
$328.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$328.03
|
| Rate for Payer: UHC Medicare Advantage |
$328.03
|
| Rate for Payer: UHCCP DNSP |
$328.03
|
|
|
PR ARTHRT GLENOHMRL JT W/JT EXPL W/WO RMVL LOOSE/FB
|
Professional
|
Both
|
$1,255.00
|
|
|
Service Code
|
HCPCS 23107
|
| Min. Negotiated Rate |
$502.00 |
| Max. Negotiated Rate |
$925.53 |
| Rate for Payer: Aetna Commercial |
$861.26
|
| Rate for Payer: Aetna Medicare |
$642.73
|
| Rate for Payer: BCBS Complete |
$502.00
|
| Rate for Payer: BCBS MAPPO |
$642.73
|
| Rate for Payer: BCN Medicare Advantage |
$642.73
|
| Rate for Payer: Cash Price |
$1,004.00
|
| Rate for Payer: Cash Price |
$1,004.00
|
| Rate for Payer: Cofinity Commercial |
$925.53
|
| Rate for Payer: Cofinity Commercial |
$861.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$642.73
|
| Rate for Payer: Healthscope Commercial |
$771.28
|
| Rate for Payer: Healthscope Whirlpool |
$771.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$674.87
|
| Rate for Payer: Nomi Health Commercial |
$771.28
|
| Rate for Payer: PACE SWMI |
$642.73
|
| Rate for Payer: PHP Medicare Advantage |
$642.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$815.75
|
| Rate for Payer: Priority Health Medicare |
$642.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$642.73
|
| Rate for Payer: UHC Medicare Advantage |
$642.73
|
| Rate for Payer: UHCCP DNSP |
$642.73
|
|
|
PR ARTHRT GLENOHUMRL JT STRNCLAV JT W/SYNVCT W/WOBX
|
Professional
|
Both
|
$1,001.00
|
|
|
Service Code
|
HCPCS 23106
|
| Min. Negotiated Rate |
$400.40 |
| Max. Negotiated Rate |
$701.05 |
| Rate for Payer: Aetna Commercial |
$652.37
|
| Rate for Payer: Aetna Medicare |
$486.84
|
| Rate for Payer: BCBS Complete |
$400.40
|
| Rate for Payer: BCBS MAPPO |
$486.84
|
| Rate for Payer: BCN Medicare Advantage |
$486.84
|
| Rate for Payer: Cash Price |
$800.80
|
| Rate for Payer: Cash Price |
$800.80
|
| Rate for Payer: Cofinity Commercial |
$701.05
|
| Rate for Payer: Cofinity Commercial |
$652.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$486.84
|
| Rate for Payer: Healthscope Commercial |
$584.21
|
| Rate for Payer: Healthscope Whirlpool |
$584.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$511.18
|
| Rate for Payer: Nomi Health Commercial |
$584.21
|
| Rate for Payer: PACE SWMI |
$486.84
|
| Rate for Payer: PHP Medicare Advantage |
$486.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$650.65
|
| Rate for Payer: Priority Health Medicare |
$486.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$486.84
|
| Rate for Payer: UHC Medicare Advantage |
$486.84
|
| Rate for Payer: UHCCP DNSP |
$486.84
|
|
|
PR ARTHRT GLENOHUMRL JT W/SYNOVECTOMY W/WO BIOPSY
|
Professional
|
Both
|
$1,134.00
|
|
|
Service Code
|
HCPCS 23105
|
| Min. Negotiated Rate |
$453.60 |
| Max. Negotiated Rate |
$893.36 |
| Rate for Payer: Aetna Commercial |
$831.32
|
| Rate for Payer: Aetna Medicare |
$620.39
|
| Rate for Payer: BCBS Complete |
$453.60
|
| Rate for Payer: BCBS MAPPO |
$620.39
|
| Rate for Payer: BCN Medicare Advantage |
$620.39
|
| Rate for Payer: Cash Price |
$907.20
|
| Rate for Payer: Cash Price |
$907.20
|
| Rate for Payer: Cofinity Commercial |
$893.36
|
| Rate for Payer: Cofinity Commercial |
$831.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$620.39
|
| Rate for Payer: Healthscope Commercial |
$744.47
|
| Rate for Payer: Healthscope Whirlpool |
$744.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$651.41
|
| Rate for Payer: Nomi Health Commercial |
$744.47
|
| Rate for Payer: PACE SWMI |
$620.39
|
| Rate for Payer: PHP Medicare Advantage |
$620.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$737.10
|
| Rate for Payer: Priority Health Medicare |
$620.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$620.39
|
| Rate for Payer: UHC Medicare Advantage |
$620.39
|
| Rate for Payer: UHCCP DNSP |
$620.39
|
|
